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Lung cancer • 8: Management of malignant mesothelioma

C Parker and E Neville

Respiratory Centre, St Mary’s Hospital, Portsmouth PO3 6AD, Hants, UK

Correspondence to:
Correspondence to:
Dr E Neville, Respiratory Centre, St Mary’s Hospital, Portsmouth PO3 6AD, Hants, UK;
edmund.neville@smail01.porthosp.swest.nhs.uk
distress and anxiety to patients, relatives, and clinicians. The incidence of mesothelioma has been steadily increasing over the past 30 years, and is expected to continue until 2020 with a projected 1300 cases each year. The 1940s male birth cohort is particularly affected, mesothelioma accounting for approximately 1% of all deaths.1–3 The incidence increases with age and is approximately 10 times higher in men aged 60–64 years than in those aged 30–34.

There is an association with the inhalation of asbestos fibres, which frequently has occurred years previously and sometimes in a seemingly low dose. Mesothelioma is rare in patients without any direct occupational exposure or indirect paraoccupational or environmental exposure.4 Current estimates suggest an occupational history is obtained in over 90% of patients.5 There is no evidence to suggest a safe or threshold level of exposure, but the risk . . .